泰脂安治疗高脂血症的系统评价

Taizhi′an Capsule in the Treatment of Hyperlipidemia:a Systematic Review

目的系统评价泰脂安治疗高脂血症的疗效和安全性。方法计算机检索Cochrane图书馆、PubMed、EMbase、中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普中文期刊服务平台(VIP)、万方数据库等数据库,纳入相关随机对照试验(RCTs),并进行评价,采用RevMan5.3软件分析数据。检索时限从建库至2018年4月20日。结果最终纳入6篇RCTs,共631例受试者。相比对照组,泰脂安试验组的血脂总疗效高于对照组[RR=1.13,95%CI(1.05,1.22),P=0.001]。治疗后总胆固醇(TC)水平与对照组效果接近[WMD=-0.33,95%CI(-0.84,0.19),P=0.21],对于合并阴虚证的病人,治疗后TC水平低于对照组[WMD=0.03,95%CI(0.22,0.28),P=0.82]。治疗后三酰甘油(TG)水平与对照组效果接近[WMD=-0.03,95%CI(-0.23,0.16),P=0.72]。治疗后高密度脂蛋白胆固醇(HDL-C)水平与对照组效果接近[WMD=0.15,95%CI(-0.06,0.36),P=0.15],对于合并阴虚证的病人,泰脂安治疗后HDL-C水平高于对照组[WMD=0.12,95%CI(0.04,0.20),P=0.004]。治疗后低密度脂蛋白胆固醇(LDL-C)水平与对照组效果接近[WMD=-0.12,95%CI(-0.44,0.20),P=0.47],对于合并阴虚证的病人,泰脂安治疗后LDL-C水平低于对照组[WMD=-0.57,95%CI(-0.79,-0.34),P<0.00001]。各组不良反应发生率差异均无统计学意义[RR=0.15,95%CI(0.01,3.60),P=0.24]。结论现有证据表明泰脂安治疗高脂血症疗效较好,对TC、TG、HDL-C、LDL-C的改善有效,在高脂血症兼阴虚证的病人中,对TC、HDL-C、LDL-C改善较明显,不良反应发生率未见与其他药物有明显差异。

Objective To evaluate the efficacy and safety of Taizhi′an capsule in treating hyperlipidemia.Methods We searched the Cochrane library,PubMed,Embase,China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBM),China Science and Technology Journal Database(VIP)and Wanfang database for randomized controlled trials(RCTs).Revman 5.3 software was used to analyzed the data.Results We included 6 RCTs and 631 subjects.Compared with the controls,the total effect rate of Taizhi′an capsule was higher[RR=1.13,95%CI(1.05,1.22),P=0.001].The total cholesterol(TC)level after treatment of Taizhi′an capsule was close to that of the control group[WMD=-0.33,95%CI(-0.84,0.19),P=0.21].For patients with yin deficiency,the TC level after Taizhian treatment was lower than that of the control group[WMD=-1.06,95%CI(-1.97,-0.15),P=0.02].After treatment of Taizhi′an capsule,the triacylglycerol(TG)level was close that in the control group[WMD=-0.03,95%CI(-0.23,0.16),P=0.72].The level of high-density lipoprotein cholesterol(HDL-C)was similar to that of the control group[WMD=0.15,95%CI(-0.06,0.36),P=0.15].For patients with yin deficiency,the level of HDL-C after treatment of Taizhi′an capsule was higher than that of the control group[WMD=0.12,95%CI(0.04,0.20),P=0.004].After treatment of Taizhi′an capsule,the level of low-density lipoprotein cholesterol(LDL-C)was close to that of the control group[WMD=-0.12,95%CI(-0.44,0.20),P=0.47].For patients with Yin deficiency,the LDL-C level was lower than that of the control group[WMD=-0.57,95%CI(-0.79,-0.34),P<0.00001].There was no significant difference in the incidence of adverse reactions among the groups[RR=0.15,95%CI(0.01,3.60),P=0.24].Conclusion Current cvidence shows that Taizhi′an capsule has a good effect in treating hyperlipidemia,and is effective in improving TC,TG,HDL-C,and LDL-C.In patients with hyperlipidemia and yin deficiency syndrome,the improvement of TC,HDL-C,and LDL-C is obvious.The incidence of adverse reactions is not significantly different from other drugs.It is recommended for clinical use,and more high-quality related studies are recommended.